Cholesterol – high and low, good and bad – has become a lynchpin of health columns, with an array of foods, medicines and other measures linked with maintaining a healthy level of the stuff.

Yet, despite the constant coverage, it remains an enigmatic topic. To help clear up the cholesterol confusion, Coach spoke to Christina Merryfield, lead dietitian at the Bupa Cromwell Hospital, to find out exactly what you should – and shouldn’t – be worrying about.

What is cholesterol and why do we need it?

Cholesterol is found in every cell of our body, that’s how essential it is. We need it to make vitamin D and also probably the biggest function is to make all the steroid hormones (like testosterone).

What’s the difference between “good” HDL and “bad” LDL cholesterol?

LDL and HDL are the carriers of cholesterol, they have two different functions. LDL carries it into the arteries but the problem is that it deposits it there. Over time, this hard deposit – often called cholesterol plaque – can potentially clog up the arteries and make them less flexible. Also if a clot forms and releases then it can block the narrower parts of the artery, and that’s when you’d get either a heart attack or a stroke. That’s the problem with LDL. The more you have, then the greater the chance of developing heart disease.

HDL is known as good because it kind of does the opposite of LDL. It takes cholesterol away from the arteries and back to the liver, where it’s broken down and then we get rid of it.

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What causes high levels of LDL?

An unhealthy diet. A lack of exercise as well. The more overweight you are, the more likely you are to have high levels of LDL and lower levels of HDL. Too much alcohol as well. It’s really diet and lifestyle. There are also people who are genetically predisposed to high cholesterol, which is an inherited condition. That’s something they can’t help.

How do you maintain a healthy level of cholesterol?

A healthy diet, plenty of wholegrains, fruits, vegetables. More of a plant-based diet, rather than high in processed foods and lots of animal products. And also exercise that can help lower or maintain bodyweight and body fat, particularly around the central stomach area.

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So it’s more about lowering LDL than raising HDL?

That’s right, although there are some foods that raise HDL. Things like oily fish and particular fats such as monounsaturated fats, found in things like olive oil.

Does saturated fat raise LDL?

Yes. Too much saturated fat is directly linked to increasing your cholesterol levels and certainly the bad cholesterol, the LDL.

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What about eggs?

Eggs don’t have much saturated fat. What they do have is cholesterol itself, dietary cholesterol. Eggs are absolutely fine, in moderation of course.

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Do young people need to worry about cholesterol?

Cholesterol levels increase over time, so the earlier you’re able to start healthy eating the better, particularly if you’ve got a family history of heart disease or high blood pressure. Think about it before middle age.

Can you be thin and have dangerous levels of cholesterol?

You can be. Overweight people are more likely to have high cholesterol, but actually people who are quite thin are often less aware of the amount of saturated fat they eat. They think, “Oh I’m thin I can eat whatever I want”. Which is not true, what’s inside could be completely different.

5 Foods That Help To Improve Cholesterol Levels

Oily Fish

These slippery characters contain polyunsaturated fats, more specifically omega 3 fats, which are great for your heart in a number of ways. All the polyunsaturated fats can lower your LDL cholesterol without messing with your HDL levels, while omega 3 fats can also reduce triglyceride levels in the blood (without going into the details, you want this) and the risk of suffering strokes and heart attacks.

The fish you are looking for are the likes of mackerel, sardines, salmon and tuna (fresh, not canned). The beneficial effect they have on the heart is the main reason the NHS recommends that we eat one or two portions of oily fish a week. But you don’t do that, do you? Best order the salmon tonight.

Oats

Wholegrains and other foods rich in soluble fibre do a great deal to battle LDL cholesterol by lowering the amount absorbed into the bloodstream via your intestine. Along with oats, other excellent sources of soluble fibre include whole barley, pulses, aubergine and sweet potatoes.

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Olive Oil

Most plant oils are great sources of “healthy” unsaturated fats. Olive and rapeseed oils contain more monounsaturated fats, while corn, sunflower and soya oils are richer in polyunsaturated fats. Replacing saturated fats like butter with either of these unsaturated types helps reduce LDL cholesterol and leaves HDL well alone. Whether you’re using it in cooking or sloshing in generous glugs when making salad dressing, it’ll help.

Avocado

The favourite food of the Instagram generation doesn’t just look good in photographs – it also does your ticker good thanks to its high levels of monounsaturated fatty acids, which help lower LDL or “bad” cholesterol levels. They also contain the essential elements potassium, which can help control blood pressure, and magnesium, which has been linked to a reduction of the risk of heart disease in men.

Nuts

Snacking on a small handful of nuts every day does wonders for your heart health because they contain high amounts of unsaturated fats. Consuming more of this type of fat lowers your levels of LDL cholesterol while raising levels of the “good” HDL kind. Just make sure you eat your nuts in their natural form, and not covered in honey, salt or sugar.

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